Doctorsrcrap: can't cry and frustrated

[Doctorsrcrap]

@Altostrata

76mg a day at the moment. Thought I'd do small cuts. As yet nothing really significantly different to report.

Out of interest whats the smallest dose safe to jump to zero from even though thats a long way off yet

[Shep]

On 11/26/2022 at 3:16 AM, Doctorsrcrap said:

@Altostrata

76mg a day at the moment. Thought I'd do small cuts. As yet nothing really significantly different to report.

Out of interest whats the smallest dose safe to jump to zero from even though thats a long way off yet

 

Please see:

 

When to end the taper and jump to zero?

 

[Doctorsrcrap]

@Shep

Thought you might not have to get as low on propranolol seeing as it's not done the same as an antidepressant 

[Shep]

3 hours ago, Doctorsrcrap said:

@Shep

Thought you might not have to get as low on propranolol seeing as it's not done the same as an antidepressant 

 

We recommend a harm-reduction, slow taper for any drug that can cause dependency. You're correct that some people are able to taper beta blockers more quickly than psychiatric drugs; however, when dealing with polypharmacy, that can get complicated and we advise caution. Please see: 

 

Tips for tapering off propranolol

 

Note from that thread:

 

 

On 7/9/2018 at 2:26 PM, Altostrata said:

Rate of tapering

Anti-hypertensives may be tapered somewhat faster than psychiatric drugs. A 10% reduction per week allows blood pressure regulation to adjust.

 

However, some people may be sensitive to reducing at that rate and must reduce slower, as the anti-hypertensives might react with other drugs the person is taking and reduction of one drug affects the balance and metabolism of the others.

 

It is also possible an anti-hypertensive might be masking another symptom or side effect, and when the anti-hypertensive is reduced, these symptoms re-emerge.

 

When changing the dosage of an anti-hypertensive, always keep daily notes on paper about your symptoms, when you take your drugs, and their dosages.If blood pressure spikes or other symptoms occur, stop tapering immediately. If the symptoms are severe, reinstate the prior dosage. You will need to taper the anti-hypertensive slower.

 

 

Also see:

 

Tapering Beta Blockers or Alpha Blockers

 

From that thread, see Alto's posts: 

 

On 10/24/2014 at 4:32 PM, Altostrata said:

Beta blockers and alpha blockers also require slow tapering, 10% reductions at a time based on the last dosage (the amount of the reduction keeps getting smaller). Taper should be slow enough not to trigger blood pressure rebound increases.

 

 

On 10/30/2014 at 8:57 PM, Altostrata said:

It's very important to taper off drugs that affect heart rhythm or blood pressure. Quitting suddenly can make you very sick.

 

I wouldn't reduce any faster than 10% per month based on the prior month's dose (not the original prescribed dose), especially until you see how your body reacts to these reductions. It's possible that the propranolol is masking withdrawal symptoms from your rapid antidepressant withdrawal. If that's the case, you definitely will want to taper slowly. 

 

Also, abrupt changes may cause kindling, especially to your already destabilized nervous system. Please see:

 

Hypersensitivity and Kindling

 

A slow taper will help prevent more kindling to your already vulnerable nervous system. 

 

 

[Doctorsrcrap]

Yesturday i did another 5% cut to propranalol.

Current daily dose 72mg.

[Shep]

Please update your signature to reflect your reductions.

 

Let us know how you're feeling over the coming days. 

[Doctorsrcrap]

Tried to update signature. It won't let me. So can't. Sorry. 

[Shep]

18 hours ago, Doctorsrcrap said:

Tried to update signature. It won't let me. So can't. Sorry. 

 

It's likely due to the number of lines in your signature. Instead of listing "1 week-62.5mg" "1 week - 50mg" etc. on multiple lines, please place all of those on the same line. Also, you may want to remove the narratives and simply stick to date, drug name, and the dose. This will free you up to include more dates and doses. 

 

Please let me know if this helps. 

[Doctorsrcrap]

Yesturday propranalol drop to 68mg.

[Altostrata]

Is your propranolol immediate-release? What times o'clock do you take it, with dosages?

[Doctorsrcrap]

I take one at around 10am and one at around 10.30pm. 

I am currently cutting from my evening dose. 

40mg in the morning and 28mg in the evening. 

Cutting from the evening dose as trying to hold down a part time job 

[Altostrata]

As you've been taking it twice a day, you'll need to keep taking it twice a day. Suggest you alternate reducing morning and evening dose to keep them approximately equivalent.

 

Tapering propranolol should not be a major tapering project. It is not a psychotropic, it's a blood pressure drug. Going too fast may cause blood pressure rebound, but people generally can go off within a month.

[Doctorsrcrap]

I'm going slowly as it is probably helping with withdrawal symptoms and we dont need to be adding fuel to the fire if you know what I mean. 

Yes I was going to get to 20mg on the evening dose and then start doing the morning one to meet it.

Does this sound ok? 

I'm doing around 5% cuts at the moment just to test the waters 

[Altostrata]

You'll want to keep the amount of drug in plasma fairly level throughout the day.

 

16 hours ago, Altostrata said:

As you've been taking it twice a day, you'll need to keep taking it twice a day. Suggest you alternate reducing morning and evening dose to keep them approximately equivalent.

 

 

[Doctorsrcrap]

I dont know how else to do it so hopefully this is fine. I have a bp monitor and am keeping regular checks 

[Doctorsrcrap]

Update

I have just tested positive for covid

[Doctorsrcrap]

My word I feel absolutely awful. Covid has really thrown a spanner in the works. Head is pounding like nothing ive ever experienced and the buzzing and zaps in my head are getting worse again. I can only assume covid has exasperated the problem. Obviously got a long list of symptoms but that's to be expected I guess

[Shep]

I'm sorry you're having to deal with Covid on top of withdrawal, @Doctorsrcrap You're right that Covid does make things worse. 

 

I would hold until you're completely recovered from Covid and do as much self-care as you can. 

[Doctorsrcrap]

@Shep

Thank you. 

I won't make another cut to the propranalol until I've recovered from this covid attack. 

[Doctorsrcrap]

I usually have odd nights of insomnia throughout the week because of withdrawal but covid is now making it basically every night. This is making it difficult to rest as is making my mood worse. It's hard to rest when your not tired your anxious and restless. All the muscles in my back and chest feel weak too. I have terrible eye pain too it my eye hurts to actually move it or touch it. 

Just having a rant. Feeling very sorry for myself. I hate this insomnia 

[Doctorsrcrap]

Still testing positive for covid but most of the covid symptoms seem to be slowly disappearing. 

However withdrawal is in full swing and am really struggling. I'm concerned contracting covid will set me back in my withdrawal recovery. 

Current symptoms are 

Akathesia

Anxiety 

Buzzing in the head

Total insomnia. Can not sleep at all. 

Irritable 

Restless

Upset

Missing menstrual cycle 

[Doctorsrcrap]

I keep worrying about things that don't need worrying about and causing me panic. Is this normal? It's like my brain just wants to worry about stuff.

Starting to feel like I'm losing my mind 

[Shep]

Oh, yes. Obsessive worrying is definitely a withdrawal symptom. 

 

Here is something that can help:

 

"Change the channel" -- dealing with cognitive symptoms

 

Learning to "change the channel" - which means to find a distraction - can keep you from going into an emotional spiral. For more, see:

 

Dealing With Emotional Spirals

 

[Doctorsrcrap]

@Shep

Thanks for the reply.

Can covid set you back on recovery and make a wave worse with mental symptoms? 

I'm starting to worry that this is jist how i am and I will never be ok.

From my history is 5 months out still early days. I think i know deep down it is. 

Starting to feel really sick again which had been better. 

It's all so upsetting. 

My emotions feel so raw and so on the edge.

Sorry if I'm a pain im just scared

[Shep]

1 minute ago, Doctorsrcrap said:

Can covid set you back on recovery and make a wave worse with mental symptoms? 

 

Of course. Any illness on top of withdrawal makes you feel worse. 

 

Try to eat as healthy as you can, drink plenty of fluids, and rest. When you start worrying and having obsessive thoughts, try playing a video game, listening to favorite music, working a puzzle, etc. Anything to get your mind on something else. Even if you can't really enjoy that activity, your brain will be steered away from the negative thoughts for a while. 

 

Try these types of distractions for just a few minutes at a time until you can build up to longer periods of time. As you practice this, you'll get better at it. 

 

Not only will it help you get through these Covid-intensified symptoms, it keeps you from going into learned helpfulness. It builds resiliency. 

[Doctorsrcrap]

@Shep

Thank you.

I worry it's not withdrawal and I'm just crazy or broken 

[Shep]

40 minutes ago, Shep said:

Here is something that can help:

 

"Change the channel" -- dealing with cognitive symptoms

 

Learning to "change the channel" - which means to find a distraction - can keep you from going into an emotional spiral. For more, see:

 

Dealing With Emotional Spirals

 

We can't do this work for you. In addition to what's linked in the above quote, here are more ideas:

 

Non-drug techniques to cope with emotional symptoms

 

Instead of continuing to post the same thing over and over again about being "crazy or broken," please work on learning to distract. The sooner you start, the sooner you'll benefit. 

 

Let us know what works for you. This will empower you. 

[Doctorsrcrap]

@Shep

Ok sorry. 

 

[Doctorsrcrap]

5 month update

Negative covid test

 

Current symptoms

Anxiety 

Akathesia 

Intrusive thoughts

Nausea 

Upset stomach

Upset 

Restless

Insomnia

Tinnitus and buzzing in the head

 

Propranalol 64mg 

[Shep]

5 hours ago, Doctorsrcrap said:

5 month update

Negative covid test

 

Very glad to read you tested negative for covid. 

 

Quote

21/11/22 76mg. 28/11/22 72mg. 05/12/22 68mg. 19/12/22 64mg. 

 

I quoted the above from your signature. Since November 21, you have reduced from 76 mg to 64 mg, which is about a 16% reduction. Since this is more than the 10% per month reduction we recommend, you may want to either updose to 68 mg, where you were on December 19th, or go into a long hold to recover, especially if you feel your symptoms are getting worse. 

 

[Doctorsrcrap]

@Shep

@Altostrata

I'm a bit confused. The guidelines for propranalol are 10% cuts weekly on the link I was provided with and I've been doing smaller than that. Am i missing something here? 

[Shep]

@Doctorsrcrap Please note this section of the thread you are referring to: 

 

On 7/9/2018 at 2:26 PM, Altostrata said:

Rate of tapering

Anti-hypertensives may be tapered somewhat faster than psychiatric drugs. A 10% reduction per week allows blood pressure regulation to adjust.

 

However, some people may be sensitive to reducing at that rate and must reduce slower, as the anti-hypertensives might react with other drugs the person is taking and reduction of one drug affects the balance and metabolism of the others.

 

It is also possible an anti-hypertensive might be masking another symptom or side effect, and when the anti-hypertensive is reduced, these symptoms re-emerge.

 

When changing the dosage of an anti-hypertensive, always keep daily notes on paper about your symptoms, when you take your drugs, and their dosages.If blood pressure spikes or other symptoms occur, stop tapering immediately. If the symptoms are severe, reinstate the prior dosage. You will need to taper the anti-hypertensive slower.

 

 

You may want to re-read the last couple of pages of your thread. You had noted this just a few days ago: 

 

On 12/17/2022 at 6:28 AM, Doctorsrcrap said:

Can covid set you back on recovery and make a wave worse with mental symptoms? 

I'm starting to worry that this is jist how i am and I will never be ok.

From my history is 5 months out still early days. I think i know deep down it is. 

Starting to feel really sick again which had been better. 

It's all so upsetting. 

My emotions feel so raw and so on the edge.

Sorry if I'm a pain im just scared

 

With this level of upticks in symptoms, regardless of it's the result of your taper or another illness, it's best to stop or at least slow down the taper to give your nervous system time to rest. 

 

So while the guidelines may state that anti-hypertensives may be tapered faster than psychiatric drugs, it depends on how that taper rate is affecting you. 

 

Just a thought, Doctorsrcrap, it may help to either updose a bit or go into a long hold and rest. 

[Doctorsrcrap]

@Shep

Ok I think i understand what you are saying. 

Alto had said that some of my problems could be coming from the propranalol so was happy to taper. 

I did wait to test negative from covid before making a reduction. 

So I'm currently taking 40mg in the morning and 24mg in the evening. 

Would I be better off changing this to 32mg in the morning and 32mg in the evening? Or can I continue as I am? I had intended to get evening dose down to 20mg and then start dropping the morning to meet it. 

 

 

[Shep]

9 minutes ago, Doctorsrcrap said:

Alto had said that some of my problems could be coming from the propranalol so was happy to taper. 

 

Yes, this is where it gets tricky - figuring out how much of your symptoms are coming from side effects and how much are coming from withdrawal. If you reduce your drug and you have upticks in symptoms, than it's safe to say it's related to withdrawal. If the symptoms were coming from side effects, those symptoms would get better as you reduce. 

 

11 minutes ago, Doctorsrcrap said:

I did wait to test negative from covid before making a reduction. 

 

This is good. But even after testing negative, it's possible to still be in recovery from having had Covid, as it can run the body down. Resting as much as possible is highly recommended for folks recovering from Covid, so that would mean being mindful of tapering too soon. 

 

12 minutes ago, Doctorsrcrap said:

So I'm currently taking 40mg in the morning and 24mg in the evening. 

Would I be better off changing this to 32mg in the morning and 32mg in the evening? Or can I continue as I am? I had intended to get evening dose down to 20mg and then start dropping the morning to meet it. 

 

How is your sleep? In other words, do you need the full 24 mg in the evening to help with sleep?

 

How do you feel in the morning? In other words, is the 40 mg sedating and slowing you down in the morning?

 

I would go by your symptoms and let them guide you in your decision. If you do decide to make a change in the morning and evening doses, I would do that without making any reductions. Since we recommend only moving doses one hour a day, you would do this by moving 8 mg from the morning dose one hour a day until you have it aligned with the evening dose, making that dose a full 32 mg. 

 

Please post your thoughts. 

[Doctorsrcrap]

@Shep

Because of work i cant really keep moving it an hour so i guess I will just keep it as it is. 

Some symptoms got better as I reduced propranalol and some got worse so who knows what's going on. 

[Altostrata]

22 hours ago, Doctorsrcrap said:

Some symptoms got better as I reduced propranalol and some got worse so who knows what's going on. 

 

Which got better and which got worse?